Nokea
A nurse is providing teaching about immunizations to a client who is pregnant. Which of the following statements should the nurse include in the teaching?
- A. The immunization for varicella should be given at least 1 month prior to delivery.
- B. You can receive the rubella immunization during the third trimester of pregnancy.
- C. The hepatitis B immunization should not be obtained until after you finish breastfeeding.
- D. You can receive the immunization for influenza at any time during your pregnancy.
Correct Answer: D
Rationale: The influenza vaccine is safe and recommended during any trimester of pregnancy to protect both the mother and the baby.
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A nurse is teaching a client who is at 10 weeks of gestation about nutrition during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. "I should increase my protein intake to 60 grams each day."
- B. "I should drink 2 liters of water each day."
- C. "I should increase my overall daily caloric intake by 300 calories."
- D. "I should take 600 micrograms of folic acid each day."
Correct Answer: A
Rationale: The correct answer is A because protein is essential for fetal development and increasing protein intake to 60 grams per day is recommended during pregnancy for optimal growth. Adequate protein intake helps in the formation of new tissues and cells.
Choice B is incorrect because while staying hydrated is important during pregnancy, the specific amount of 2 liters per day is not a standard recommendation and may vary depending on individual needs.
Choice C is incorrect as increasing overall daily caloric intake by 300 calories is a general guideline, not specific to the client's gestational age.
Choice D is incorrect as while folic acid is crucial during pregnancy to prevent birth defects, the recommended daily intake is usually 400-800 micrograms, so 600 micrograms is within the range but not the best answer.
What is the recommended method of feeding for a newborn with phenylketonuria (PKU)?
- A. Breastfeeding
- B. Formula feeding
- C. Lowphenylalanine formula feeding
- D. All of the above
Correct Answer: C
Rationale: Lowphenylalanine formula feeding is recommended for newborns with PKU.
A nurse is assessing a newborn whose mother had gestational diabetes mellitus. The nurse should monitor for which of the following findings as a manifestation of hypoglycemia?
- A. Abdominal distention
- B. Petechiae
- C. Increased muscle tone
- D. Jitteriness
Correct Answer: D
Rationale: The correct answer is D: Jitteriness. In newborns of mothers with gestational diabetes mellitus, hypoglycemia can occur due to the abrupt cessation of the maternal glucose supply. Jitteriness is a common manifestation of hypoglycemia in newborns. This is because the brain is highly dependent on glucose for energy, and low blood sugar levels can affect neurological function, leading to symptoms like jitteriness. Abdominal distention, petechiae, and increased muscle tone are not typical manifestations of hypoglycemia in newborns with a history of maternal gestational diabetes mellitus.
Which of the following is a potential complication of a forceps-assisted delivery?
- A. Fetal distress
- B. Maternal hemorrhage
- C. Neonatal brachial plexus injury
- D. All of the above
Correct Answer: C
Rationale: Forceps-assisted delivery can sometimes result in neonatal brachial plexus injury due to the pressure applied during delivery.
A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?
- A. I can use a sleep sack to keep my baby warm in the car seat.'
- B. My baby will need a car seat challenge test before discharge.'
- C. The car seat should be positioned in the car at a 45-degree angle.'
- D. When my baby is 1 year old, I can turn their car seat facing forward.'
Correct Answer: C
Rationale: The correct answer is C: "The car seat should be positioned in the car at a 45-degree angle." This is correct because newborns and premature babies (delivered at 38 weeks) have less muscle tone and are at risk of airway compromise if the head falls forward in the car seat. Placing the car seat at a 45-degree angle helps keep the baby's airway open and prevents slumping.
A: "I can use a sleep sack to keep my baby warm in the car seat." - This is incorrect as bulky clothing or blankets should not be used in the car seat as they can compress in a crash and create a loose harness fit.
B: "My baby will need a car seat challenge test before discharge." - This is incorrect as car seat challenge tests are usually done for premature infants born before 37 weeks.
D: "When my baby is 1 year old, I can turn their car seat facing forward." - This is incorrect as rear